Provider Demographics
NPI:1124278304
Name:SCAVELLA, EMILY M (PA-C)
Entity type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:M
Last Name:SCAVELLA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:240 W 11TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1758
Mailing Address - Country:US
Mailing Address - Phone:814-452-2218
Mailing Address - Fax:814-455-2925
Practice Address - Street 1:240 W 11TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1758
Practice Address - Country:US
Practice Address - Phone:814-452-2218
Practice Address - Fax:814-455-2925
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2010-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA053545363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00670434OtherRAILROAD MEDICARE
PA142169FTGMedicare PIN